Surgical wound clip applier with disposable clip magazine

ABSTRACT

A surgical clip applier for surgical wounds is disclosed which is semi-automatic in operation, operated with one hand, easily disassembled or assembled without tools as for cleansing or sterilizing in an autoclave and includes a low cost disposable clip magazine. Individual clips are advanced to a position where they are applied selectively to the wounded area and, as soon as one has been applied and the mechanism released, the applier operates automatically to be ready for the next application. This enables the surgeon to close a wounded area in much shorter time than could be done by suturing, or by individually applying each clip.

United States Patent 91 Cooke [451 Dec. 11, 1973 1 SURGICAL WOUND CLIPAPPLIER WITH DISPOSABLE CLIP MAGAZINE [76] Inventor: John R. Cooke, FourMile Canyon,

Boulder, Colo. 80302 [22] Filed: July 24, 1972 [21] Appl. No.: 274,503

[52] U.S. Cl. 29/243.56, 72/410 [51] int. Cl... B23p 11/00, E05b 19/06,EOSb 19/26 [58] Field of Search 29/243.56, 212 D; 72/410; 227/108, 19

[56] References Cited UNITED STATES PATENTS 3,015,824 1/1962 Richardson72/410 X 3,646,801 3/1972 Caroli 227/19 2,735,322 2/1956 Meisler29/243.56

2,897,502 8/1959 Schafroth.... 227/108 3,526,944 9/1970 Cherup 29/212 DPrimary Examiner-James L. Jones, Jr. Attorney-Wm. Griffith Edwards [57]ABSTRACT A surgical clip applier for surgical wounds is disclosed whichis semi-automatic in operation, operated with one hand, easilydisassembled or assembled without tools as for cleansing or sterilizingin an autoclave and includes a low cost disposable clip magazine.Individual clips are advanced to a position where they are appliedselectively to the wounded area and, as soon as one has been applied andthe mechanism released, the applier operates automatically to be readyfor the next application. This enables the surgeon to close a woundedarea in much shorter time than could be done by suturing, or byindividually applying each clip.

13 Claims, 19 Drawing Figures 'PATENTEU DEC '1 I $975 SHEET 10F 4 FIG. 2

PATENIEDUEC 11 1975 3777355 SHEET 2 0F 4 PATENTEDBEB 1 1 i975 SHEET 3 OF4 FIG.4

F IG. l4

PMENTED DEC 1 1 I975 SHEET QUF Q FIG.8

FIG. 7

FIGS

FIGII FIG. IO

FIG. l2

SURGICAL WOUND CLIP APPLIER WITH DISPOSABLE CLIP MAGAZINE My inventionrelates to the application of metal clips to close surgical wounds andparticularly to an improved device for applying such clips in rapidsuccession to speed and facilitate the closing of a wound.

Metal clips applied one at a time have come into use for closingsurgical wounds and are particularly useful in facilitating closures andfor favorable post operative cosmetics. Various devices have beenprovided for bending or closing surgical clips in position to grip thetissue adjacent to a wound, and some such devices have been providedwhich include a magazine from which clips are delivered to a clipclosing mechanism. It is desirable to provide effective and reliablemagazine type clip applying devices which may be readily disassembledfor autoclaving and for servicing and, accordingly, it is an object ofmy invention to provide an improved surgical clip applying device.

It is another object of my invention to provide a magazine type devicefor applying surgical clips which is easily assembled and readilydisassembled for purposes of servicing and for autoclaving.

It is another object of my invention to provide an improved clipmagazine equipped surgical clip applier which may easily be manipulatedand used with one hand.

It is another object of my invention to provide an improved applier forsurgical clips of the type having ears or lugs separated during theclosing ofthev clip and which facilitate adjustment, or opening of theclip when a a wound has healed.

It is a further object of my invention to provide an improved device forapplying surgical clips which is positive and reliable in operation.

It is a further object of my invention to provide a manually actuateddevice for applying surgical clips to the lips of wounds including animproved arrangement for holding the device and for applying fingerpressure during application of the clips.

Briefly, in carrying out the objects of my invention in one embodimentthereof, I provide a clip holding and applying structure includingstamped metal front and rear wall members which are formed to providefinger grips or catches and an actuating member slidable between the twowall members for actuating a forceps also located between the members.Interengaging cam surfaces on the forceps and on the actuating membertogether with cam or guide surfaces on one of the wall surfaces causethe forceps to move downwardly to a position externally of thestructure. Surgical clips are supplied to the bottom zone of thestructure where they are gripped one at a time by the forceps and moveddownwardly from the structure into position to attach to the lips of awound as the forceps are operated. The clip applier assembly may betaken apart easily by releasing resilient catch portions of one of thewall members so that the assembly is readily serviced and theunassembled parts may be autoclaved when separated. A magazine type clipsupply device extends outwardly from the lower zone of the wall membersand is readily detachable. The clip magazine is also made up ofmaterials not affected by autoclave temperatures and is easilysterilized.

The features of novelty which characterize my invention are pointed outwith particularity in the claims appended to and forming a part of thisspecification. My

invention itself, however, both as to its organization and manner ofoperation, together with further objects and advantages thereof, maybest be understood by reference to the following description taken inconnection with the accompanying drawings in which:

FIG. 1 is an isometric view of a surgical clip applier embodying myinvention;

FIG. 2 is a sectional side elevation taken along the line 22 of FIG. 1;

FIG. 3 is an exploded isometric view of the applier of FIG. 1;

FIG. 4 is a sectional view along the line 44 of FIG.

FIG. 5 is an enlarged side elevation view of a portion of the structureof FIG. 1;

FIGS. 6, 7 and 8 are sectional views of the portion shown in FIG. 5illustrating three steps in the assembly of the applier;

FIGS. 9, 10 and 11 are enlarged sectional elevation views of the lowerpart of the portion of FIG. 5 illustrating three stages in the attachingof the clip magazine to the applier;

FIG. 12 is a rear elevation view of the portion shown in FIG. 11;

FIG. 13 is an enlarged elevation view of a portion of the bottom leftend of the device shown in FIG. 2;

FIG. 14 is an enlarged sectional view taken along the line 14-14 of FIG.4; and

. FIGS. 15A through 15E illustrate successive stages in operation of theclip closing forceps.

Referring now to the drawings, the surgical clip applier illustrated inFIG. 1 comprises an upright body portion 10 and a horizontally extendingclip magazine 11 which is detachably secured to the lower end of thebody 10. The body portion 10 comprises front and back outer walls 12 and13 which terminate upwardly in arcuate outwardly extending finger gripsl4 and 15,

' respectively. Slidably mounted within the body 10, be-

thumb plate 17 extends directly over the actuator. The

actuator is biased upwardly by a spring 20 attached thereto and bearingon the top surface of the finger member 15 of the rear wall. A string ofparallel laterally adjacent aligned clips is contained within themagazine 11 and is pressed forward by a spring which urges a pressuremember, or follower, 21 toward the body 10 to supply clips as they areused one at a time by operation of the actuator l6. This arrangement ofthe string of clips and the follower 21' is shown in FIG. 2, whichillustrates the follower pressing against clips 22 fourteen of which areillustrated in the string. The follower is urged toward the applier by aspring indicated at 23. The spring engages a seat 24 on the follower andextends rearwardly within the magazine and extends into a reducedportion 25 thereof.

A clip closing forceps 26, shown in FIGS. 2 and 3, comprises two jaws 27and 28 pivoted together on a pin 30 and mounted between the actuator 16and the front wall 12. The front wall 12 is provided with'a verticalslot 31 extending therethrough, and the pin 30 extends through the slotinto engagement with a leaf spring 32 which is securely attached tofront wall 12 by a rivet 33 and a bent lip or flange 34 which extendsinto a slot 35 in the wall 12. The spring 32 is provided to press theforceps against the actuator 16 and to retain the forceps pin 30 eitherat the top of the slot 31 in an upper position in an outwardly humpedportion 32a of the spring as shown in FIG. 2, or in a lower position atthe bottom end of the slot where they are retained by an outwardlycurved portion 36 of the spring.

The forceps jaws 27 and 28 as shown in FIG. 3 are provided with camsurfaces 37 and 38 into which project the pins 40 and 41 on the actuator16, the upper end of the forceps jaws have rounded portions 42 and 43,respectively, which are arranged to engage cam surfaces 44 and 45,respectively, formed in the front wall 12. The jaws 27 and 28 areprovided with inwardly facing recesses or seats 46 and 47 which arepositioned to receive the outer ends of surgical clips supplied theretofrom the magazine 11. The manner in which the forceps are actuated bymovement of the actuator 16 is described in detail hereinafter. Themagazine or cartridge 1 l as shown in FIGS. 1 to 4 comprises top andbottom wall members 48 and 49 which are formed to provide guides for thetravel of the follower 21 and which are shaped to guide the string ofsurgical clips. The follower 21 extends across the magazine 11 and itsouter ends ride in slots formed by upwardly offset lower portions 51 ofthe top wall 48 as clearly indicated in FIG. 1. The follower 21 moves inthese slots and may be pressed against the pressure spring 23 until itreaches a position at the far righthand end of the slot where there areupward and downward offsets of the slots indicated at 52 and 53. Theseoffsets allow the follower 21 to be tipped about its lower edge,indicated as of rocker configuration at 54, and when tipped the springurges the follower against forward stops formed by the offsets of thecasing and holds the follower in position so that the clips may befreely moved in and out of the magazine.

Each clip when it enters the zone below the actuator is in the positionindicated by the clip 56 in FIG. 2. The

actuator is provided with a blade or knife 57 along its bottom edge andwhen it is pressed down this blade separates the clip 56 from the nextadjacent'clip in the magazine, then, as the actuator moves farther downit strikes a retaining lip or tab 58 formed on the actuator end of thebottom half of the magazine 49. The lip 58 holds the clip 56 in positionuntil it can be gripped by the jaws 46 and 47 and then proceeddownwardly to bend the lip 58 down and back against the magazine toallow. the clip to proceed outwardly from the ends of walls 12 and 13into a position to be clamped about the lips of a wound which is to beclosed. The manner in which the forceps operate upon depression of theactu ator 16 is described in detail below.

FIG. illustrates the assembled upright unit and in this figure the backwall 13 which has two side pieces or'legs 60 and 61 (both shown in FIG.3) secured along the edge of the wall along the front corners to provideguides for the slide 16 includes rearwardly bent lower portions 62 and63 which, as shown in FIG. 5, are used as locks. In FIG. 5 the portion63 is illustrated and this figure shows a foot 64 at the bottom of thisportion and in engagement with an inwardly extending portion 65 of alower rearward extension 66 on the front wall 12. This lower portion isshown in FIG. 3. The other side of the lower end of the wall 12 isconstructed similarly to the righthand side illustrated, and the farside of the wall 13 as viewed in FIG. 3 also includes a foot at thelower end of the bent portion 62 as indicated at 67. When the unit is tobe assembled it is understood that the front spring 32 has been rivetedsecurely in place on the front side of the wall 12. The forcepsare thenplaced in position against the inner side of the wall 12 with the pin 30in the upper end of the slot 31 engaging the upper stop or top portionof 32a of the spring. The slide or actuator 16 is then placed over theforceps with the pins 40 and 41 in engagement with the cam recesses 37and 38, respectively. The assembly is then completed by placing the backwall 13 over the slide 16 so that the slide lies between the guidemembers 60 and 61. The initial position for insertion of the back wall13 in this matter is illustrated in FIG. 6 where the foot 64 of the bentportion 63 is shown at the upper end of the inturned portion 65 of thelarge section 66 on the wall 12. The wall 13 is then pressed intoposition with the slide 16 lying between the side guides 60 and 61, andwith slots 69 and 70 in the upper side edges of the guides 60 and 61, inalignment with outwardly and inwardly extending retaining lugs on thewall 12, one of these lugs being shown at 71 on the righthand side ofthe wall as viewed in FIG. 3. The cutaway portions 69 and 70 of theguides 60 and 61 allow the guides to be moved past the lugs on the upperends of the wall 12 so that the wall can be straightened to a positionparallel to the front wall 12 as shown in FIG. 7. The wall 13 is thenmoved downwardly so that the edge of the wall above the recesses 69 and70 moves past the inturned lugs on the wall 12, as exemplified by thelug 71, and the wall 13 is then returned to a straight position. Thiswall is then moved downwardly until the foot 64 passes the lower end ofthe lug 65 on the wall 12 and snaps to a locked position as illustratedin FIG. 8. When the wall 13 reaches this position forwardly projectinglugs 72 and 73 at the tops of the guides 60 and 61, respectively, engagethe tops of the wall 12 facing the inturned portions exemplified by theportion 71. The wall 13 is thus locked against removal. When it isdesired to take the applier apart again, the foot 64 is pressedforwardly until it clears the wall projection 65 whereupon the wall 13may be moved upwardly until the side recesses 69 and 70 allow it to moveaway from the wall 12.

The sloping guides 44 and 45 which are used in guiding the movement ofthe forceps 26 are stamped in the wall 12 to provide upper and lowerside walls on both sides, the ones on the near side in FIG. 3 beingindicated at 74 and 75, respectively, the sloping portion 45 joiningthese two upright walls and the catch or lug 71 being formed on aportion of the wall adjacent the upper portion 74.

The clip magazine portion 11 may, by way of example, be made fromplastic materials which are able to withstand autoclaving temperatures.By way of example, one material useful for this purpose ispolypropylene, a synthetic plastic, which is flexible and has goodhinging characteristics and is dimensionally and chemically stable atautoclaving temperatures. The top 48 as shown in FIG. 3 is molded with alongitudinal ridge 77 which is in alignment with a raised ridge 78 inthe lower portion of 49. The ridge 78 provides grooves 80 and 81 in thelower portion and these grooves receive the outer endsof the surgicalclips, the upwardly extending ears or releasing members lying in theouter extending groove formed by the ridge 77. The spring assembly andthe. follower 21 are arranged between the halves 48 and 49 of themagazine housing and the edges of the housing are welded or otherwisesuitably bonded together to form the complete structure; The completemagazine may be autoclaved or maybe handled as a disposable item, eachitem being loaded at the factory with the required number of surgicalclips, and the front or open end of the cartridge sealed by a removableplastic wall.

The walls 48 and 49 include vertical flanges at their front ends, thesebeing indicated at 82 and 83' respectively. The clipretaining lip 58 ismolded as a portion of the front wall 83 of the lower half wall 49. Thelip 58 forms, in effect, an extension of the wall forming the ridge 78in the member 49 and is V-shaped in cross section starting at the top of78 and forming a V as clearly indicated in FIG. 2, where the V isindicated at 84.

When the magazine 11 is to be attached to the clip applier it is firstplaced in a position illustrated in FIG. 9 in which the downwardlyextending flange 83 of the half 49 of the magazine is immediately abovethe lug or stop 65 of the front wall. The flange 83 is then pressed downbetween the stop 65 and the lower end 63 of the guide 61 so that it isin a position such as illustrated in FIG. 10. It is then pressed downuntil it hits the foot 64 of the guide 61 and then is rotated upwardly,the flange 82 then lying below and in contact with the lower edge of therear of the back wall 13. The thickness of the flange 83 is less thanthe length of the foot 64 so that when it is in place, as shown in FIG.11, the foot 64 still engages the stop 65 and prevents removal of theback wall of the applier. The magazine is then locked in place and readyfor delivery of the clips one at a time to the clip applying device 10.In FIG. 12 the spaces between the dotted lines 86 and 87 and the solidlines representing the sides of the wall 13 indicate the overlap betweenthe wall 13 and the guides 60 and 61, respectively.

FIG. 13 is an enlarged side elevation view of the holding tab or lip 58and its V-shaped connection to the top of the central wall 78 of thelower half 49 of the magazine, the parts being shown in their compressedposition when the actuator blade 16 has moved downwardly past the normalposition of the lip 58, which is indicated in dotted lines. The plasticforming the lip 58 and the V 84 is provided with transverse holes orrecesses 88 and 89 which provide a weaker cross section to assure a moreeffective operating hinge. When the blade 16 is again retracted, thenext clip on the ridge 78 moves into position and is held by the lip 58until the blade 16 is again actuated to retract the lip and move theclip downwardly into clamping position.

When it is desired to compress the spring 23 and prevent discharge ofthe clips carried in the magazine, the clip follower 21 is moved bygripping itsend pieces on either sideof the magazine and moving thefollower 21 back against the pressure of the'spring until it reaches thecatches or stops 52 and 53 and is turned counterclockwise as shown inFIG. 14 to engage the stops and prevent forward movement of thefollower. An upward blade 92 extends from the rocker 84 vertically andrides in the inverted trough 77 of the upper wall member 48. The rocker54 and the projection 92 act together to engage the clips and move themforward in the magazine.

plate 17. Each time the surgeon wishes to place a clip in position on awound, he holds the lower end of the applier at the desired position ofthe wound and presses the actuator 16 downwardly to force a clip held bythe forceps downwardly into position and on forward pressure to closethe clip about the two lips of the wound and then releases the clip toleave it in place. This operation is repeated as often as necessary toplace therequired number of clips for the wound.

The manner in which the forceps are actuated to effect the foregoingoperation of the surgical clip applier is indicated in FIGS. 15A through15E. FIG. 15A illustrates the forceps in the completely retractedposition of the actuator 16. A clip 94 from the magazine has been movedinto the zone between the jaws of the forceps and is in spacedrelationship to the clipping recesses 46 and 47. Upon initial downwardmovement of the actuator 16 the pins 40 and 41 move over the camsurfaces 37 and 38 a sufficient distance to bring the recesses of thejaws into engagement with the ends of the clip. The actuator 16 is thenmoved downwardly until the pin of the forceps has been snapped out ofthe top recess of the spring 32 and has moved'down in the slot 31 nearthe bottom thereof.- In this position the upper ends of the forcepsindicated at 42 and 43 have just reached the outwardly and downwardlyextending surfaces of the cam guides 44 and 45, the blade has descendedand separated the clip from thenext adjacent clip and has bent the lip58 downwardly so that the clip has moved past the lip 58 as the forcepsmove down. Further downward movement of the actuator 16 presses theforceps jaws together and they compress the clip to bring its pointedends or spurs together at the rim of the wound. The upper ends or cars95 of the clip part as the clip is closed on the wound and are thusavailable to be squeezed by a forceps or other instrument and movedapart when it is desired to adjust or remove the clip from the woundafter healing. The actuator 16 is then withdrawn whereupon the jaws aremoved apart to release the clip and move upwardly past the slopingguides 44 and 45 and toward the original position of the forceps. Inmoving to their original position the forceps are moved upwardly so thatthe spring 32 bends outwardly to allowthe pin 30 to pass upwardly to itsoriginal position. Thus the two positions of the pin 30 determined bythe spring 32 provide positions wherein the force of the actuatorutilizes the cam surfaces to actuate the forceps both in the forward andDuring the use of the surgical clip applier, as de- 6 scribed above andshown in the drawings, the surgeon holds the clip between two fingersengaging the finger grips 14 and 15 and his thumb engaging the thumbretracting directions.

The metal parts of the applier are made from stainless ,steel sheet orother suitable non-corrodible metal so that autoclaving is effective tosterilize the metal parts and the parts do not corrode from use.

While the invention has been described in connection with a specificembodiment and application, various other embodiments will occur tothose skilled in the art. Therefore, it is not desired that theinvention be limited to the details illustrated and described and it isintended by the appended claims to cover all modifications which fallwithin the spirit and scope of the invention as determined by the priorart.

I claim: 4

1. A surgical clip applier for closing surgical wounds, comprising:

a rigid body member having spaced front and back portions and anactuator member slidably mounted between said portions,

a pair of forceps pivoted together and slidably mounted between saidmembers and adjacent said actuator member for sliding movement in thesame direction as said actuator member,

means for biasing said actuator member upwardly away from the bottom endof said body,

stop means for limiting the length of the path of movement of saidforceps,

camming means interconnecting said forceps and said actuator member formoving said forceps outwardly from the bottom end of said body whileclosing said forceps,

means detachably secured to the lower end of said body for supplyingsurgical clips to the interior thereof, each clip in turn beingpositioned in alignment with said forceps and in position to be closedby closing of said forceps, said forceps having a configuration forgripping a clip and holding it .while it is being closed by closing ofthe forceps,

said actuator upon downward movement separating the front clip from thenext adjacent clip in said supplying means, and

means for manually holding said body member and for pressing saidactuator downwardly therein against said biasing means to bend and closea clip at a position beyond the lower end of said body.

2. A surgical clip applier as set forth in claim 1 wherein said membersinclude quickly detachable means for holding said front and back membersin assembled relationship with said forceps and said actuator.

3. A surgical clip as set forth in claim 2 wherein said quicklydetachable means comprises:

a resilient part of said back portion and a spaced projection on saidfront portion engaging one another when said members are assembled and afoot on said resilient part hooking oversaid projection to lock saidassembly together and stop means for preventing release of said foot byrelative sliding movement of said front and back portions.

4. A surgical clip applier as setforth in claim 3 wherein said resilientportion further engages and holds said detachable clip supplying meanswhen positioned on said assembly, said supplying means having a flangeheld against said projection by said resilient portion.

5. A surgical clip applier as set forth in claim 1 including a flexiblelip on said detachable clip supplying means for holding the front clipin position in said body member for engagement by said forceps, said lipbeing flexed out of the path of the clip by downward movement of saidactuator.

6. A surgical clip applier for closing surgical wounds, comprising:

a body having a hollow base member and an upright hollow member at aforward end of said base member and formed of a material capable ofwithstanding sterilizing temperatures without deterioration;

a surgical clip magazine assembly seated in the hollow portion of thebase for holding a string of clips and including means for urging thestring forwardly toward said upright member so as to maintain an endclip in the upright member at the forward end of the base member; I

said upright member having a cam cover at its forward end, including anupper grip portion and a lower slot, said upright member having a slideguide at its rear end joined to the base member and including an uppergrip portion, and having a sliding blade, including an upper springportion, supported for manual depressing movement along the slide guideto separate the forward end clip from the next adjoining clip in saidmagazine assembly, and retractable by action of said upper springportion upon termination of the manual movement;

two cooperative forceps jaws mounted for pivotal movement on a pivotextending through the slot in said cam cover, each jaw having a camsurface; and

cooperative means on said sliding blade for engaging said cam surfacesduring the depressing movement and moving said jaws in gripping relationto the separated clip whereby said clip has its extremities closed inguided clamping juxtaposition about tissue adjoining a wound and isreleased from clamping contact with said forceps by retracting movementof said blade after the clip is clamped.

7. A clip applier as recited in claim 6, in which a clip string isdetachably secured within said hollow portion of the base member forreplacement and removal as required.

8. A clip applier as recited in claim 6, including spring means formounting said pivot in alternative upper and lower positions in the slotin said cover and in which said pivot on which the jaws are mounted isretained during initial action of said cooperative forceps jaws and thento the lower position so as to properly align the jaws over the ends ofthe clip.

9. A clip applier as recited in claim 6, in which the cam cover, slidingblade and slide guide are confined at their sides by structure normallyclamped onto the slide guide and manually removable from the slide guidefor cleaning, inspection or replacement of the cover, sliding blade andslide guide.

10. A clip applier as recited inclaim 6, in which the grip portion ofthe slide guide limits the extent of movement of the spring portion ofthe sliding blade.

11. A clip applier as recited in claim 6, in which the sliding bladeterminates at its lower end in a cutting edge.

l2.-A clip applier as recited in claim 6, in which the forceps jaws areof the same configuration and afford interchangeable mounting of thejaws.

13. A clip applier as recited in claim 6, including means for limitingupward movement of the sliding blade.

1. A surgical clip applier for closing surgical wounds, comprising: arigid body member having spaced front and back portions and an actuatormember slidably mounted between said portions, a pair of forceps pivotedtogether and slidably mounted between said members and adjacent saidactuator member for sliding movement in the same direction as saidactuator member, means for biasing said actuator member upwardly awayfrom the bottom end of said body, stop means for limiting the length ofthe path of movement of said forceps, camming means interconnecting saidforceps and said actuator member for moving said forceps outwardly fromthe bottom end of said body while closing said forceps, means detachablysecured to the lower end of said body for supplying surgical clips tothe interior thereof, each clip in turn being positioned in alignmentwith said forceps and in position to be closed by closing of saidforceps, said forceps having a configuration for gripping a clip andholding it while it is being closed by closing of the forceps, saidactuator upon downward movement separating the front clip from the nextadjacent clip in said supplying means, and means for manually holdingsaid body member and for pressing said actuator downwardly thereinagainst said biasing means to bend and close a clip at a position beyondthe lower end of said body.
 2. A surgical clip applier as set forth inclaim 1 wherein said members include quickly detachable means forholding said front and back members in assembled relationship with saidforceps and said actuator.
 3. A surgical clip as set forth in claim 2wherein said quickly detachable means comprises: a resilient part ofsaid back portion and a spaced projection on said front portion engagingone another when said members are assembled and a foot on said resilientpart hooking over said projection to lock said assembly together andstop means for preventing release of said foot by relative slidingmovement of said front and back portions.
 4. A surgical clip applier asset forth in claim 3 whErein said resilient portion further engages andholds said detachable clip supplying means when positioned on saidassembly, said supplying means having a flange held against saidprojection by said resilient portion.
 5. A surgical clip applier as setforth in claim 1 including a flexible lip on said detachable clipsupplying means for holding the front clip in position in said bodymember for engagement by said forceps, said lip being flexed out of thepath of the clip by downward movement of said actuator.
 6. A surgicalclip applier for closing surgical wounds, comprising: a body having ahollow base member and an upright hollow member at a forward end of saidbase member and formed of a material capable of withstanding sterilizingtemperatures without deterioration; a surgical clip magazine assemblyseated in the hollow portion of the base for holding a string of clipsand including means for urging the string forwardly toward said uprightmember so as to maintain an end clip in the upright member at theforward end of the base member; said upright member having a cam coverat its forward end, including an upper grip portion and a lower slot,said upright member having a slide guide at its rear end joined to thebase member and including an upper grip portion, and having a slidingblade, including an upper spring portion, supported for manualdepressing movement along the slide guide to separate the forward endclip from the next adjoining clip in said magazine assembly, andretractable by action of said upper spring portion upon termination ofthe manual movement; two cooperative forceps jaws mounted for pivotalmovement on a pivot extending through the slot in said cam cover, eachjaw having a cam surface; and cooperative means on said sliding bladefor engaging said cam surfaces during the depressing movement and movingsaid jaws in gripping relation to the separated clip whereby said cliphas its extremities closed in guided clamping juxtaposition about tissueadjoining a wound and is released from clamping contact with saidforceps by retracting movement of said blade after the clip is clamped.7. A clip applier as recited in claim 6, in which a clip string isdetachably secured within said hollow portion of the base member forreplacement and removal as required.
 8. A clip applier as recited inclaim 6, including spring means for mounting said pivot in alternativeupper and lower positions in the slot in said cover and in which saidpivot on which the jaws are mounted is retained during initial action ofsaid cooperative forceps jaws and then to the lower position so as toproperly align the jaws over the ends of the clip.
 9. A clip applier asrecited in claim 6, in which the cam cover, sliding blade and slideguide are confined at their sides by structure normally clamped onto theslide guide and manually removable from the slide guide for cleaning,inspection or replacement of the cover, sliding blade and slide guide.10. A clip applier as recited in claim 6, in which the grip portion ofthe slide guide limits the extent of movement of the spring portion ofthe sliding blade.
 11. A clip applier as recited in claim 6, in whichthe sliding blade terminates at its lower end in a cutting edge.
 12. Aclip applier as recited in claim 6, in which the forceps jaws are of thesame configuration and afford interchangeable mounting of the jaws. 13.A clip applier as recited in claim 6, including means for limitingupward movement of the sliding blade.